目的：研究滋肾活血安胎汤对肾虚血瘀型复发性流产患者激素水平及子宫动脉异常情况的影响。方法：80例北京大兴区妇幼保健院2019年3月―2022年3月收治的肾虚血瘀型复发性流产患者为随机分为常规组（40例）和中药组（40例）。常规组进行常规保胎处理,并采用地屈孕酮、维生素E胶丸、低分子肝素进行治疗,在常规组基础上,中药组采用滋肾活血安胎汤进行治疗,两组均治疗45 d,并随访至患者分娩。统计两组治疗45 d后临床疗效及随访期间妊娠结局,比较两组治疗前及治疗45 d后中医证候积分、血清激素水平、凝血功能及子宫动脉、子宫内膜异常情况。结果：治疗45 d后,中药组总有效率（92.50%）高于常规组（72.50%）;随访期间,中药组妊娠成功率（82.50%）高于常规组（62.50%）。治疗45 d后与治疗前比较,两组各项中医证候积分及血清D-二聚体（D-dimer,D-D）、纤维蛋白原（fibrinogen,FIB）、纤溶酶原激活物抑制物-1（Plasminogen activator inhibitor-1,PAI-1）水平、子宫动脉和子宫内膜搏动指数（pulsatility index,PI）、子宫内膜阻力指数（resistance index,RI）、子宫动脉收缩末期峰值/舒张末期峰值（End-systolic peak/end-diastolic peak,S/D）降低,中药组低于常规组;两组血清E2、P、β-HCG水平升高,中药组高于常规组;两组部分凝血活酶时间（aPTT）延长,中药组长于常规组。结论：滋肾活血安胎汤联合常规保胎处理可改善肾虚血瘀型复发性流产患者中医证候,调节激素水平,改善患者凝血功能,促进子宫动脉及子宫内膜血液灌注,改善患者妊娠结局,疗效较好。

Objective To study the effects of Zishen Huoxue Antai decoction on hormone levels and uterine artery abnormalities in patients with recurrent abortion of kidney deficiency and blood stasis type. Methods A total of 80 patients with recurrent abortion of kidney deficiency and blood stasis type admitted to Beijing Daxing District Maternal and Child Health Hospital from March 2019 to March 2022 were randomly divided into the conventional group（40 cases）and the traditional Chinese medicine group（40 cases）by random number table method. The conventional group received routine fetal preservation treatment,and was treated with dydrogesterone,vitamin E capsules,and low molecular weight heparin;the traditional Chinese medicine group was treated with Zishen Huoxue Antai decoction on the basis of the conventional group. Both groups were treated for 45 d,and the patients were followed up until delivery. The clinical efficacy of the two groups after 45 d of treatment and the pregnancy outcome during follow-up were analyzed,and the traditional Chinese medical syndrome scores,serum level of hormone,coagulation function,uterine artery and endometrial abnormalities were compared between the two groups before and after 45 d of treatment. Results After 45 d of treatment,the total effective rate of the traditional Chinese medicine group（92.50%）was higher than that of the conventional group（72.50%）;During the follow-up period,the success rate of pregnancy in the traditional Chinese medicine group（82.50%）was higher than that in the conventional group（62.50%）. During the follow-up period,the pregnancy success rate in the traditional Chinese medicine group was higher than that in the conventional group. After 45 d of treatment compared with before treatment,The scores of nocturnal frequent urination,lumbar and knee tenderness,cold limbs,dark face,dizziness and tinnitus,serum levels of D-D,FIB,PAI-1,uterine artery and endometrial PI,RI,S/D decreased in both groups. The traditional Chinese medicine group was lower than the conventional group. Serum levels of E2,P and β-HCG in two groups increased,and those in the traditional Chinese medicine group were higher than those in the conventional group. The aPTT in two groups was longer,and those in the traditional Chinese medicine group were longer than those in the conventional group. Conclusion Zishen Huoxue Antai decoction combined with routine abortion treatment could improve the traditional Chinese medical syndrome of patients with recurrent abortion of kidney deficiency and blood stasis,regulate the level of hormone,improve the coagulation function of patients,promote uterine artery and endometrial blood perfusion,improve the pregnancy outcome of patients,and the curative effect was good.